118,402 research outputs found
The rehabilitation definition for scientific research purposes by Cochrane Rehabilitation – first results
No full textBackground. Since its launch in 2016, Cochrane Rehabilitation (CR) has increasingly found the need to better define what rehabilitation is and what is not. We found that currently available definitions of rehabilitation fall short with regard to defining exactly what is needed for research purposes, specifically inclusion and exclusion criteria on an operational level.
Objectives. The aim was to specify a definition of rehabilitation suitable for research purposes that also defines inclusion and exclusion criteria.
Methods. The methodology was developed based on discussions during the CR Executive and Methodology Committees Meetings and with the Advisory Board of CR, which includes all relevant rehabilitation stakeholders, during its meeting in Kobe in June 2019. The methodology was then refined to include: (1) a survey involving a) the Advisory and b) the Executive Committee members and c) the participants invited to the consensus meeting here reported to collect the current definitions promoted by CR stakeholders, (2) a consensus meeting (CM) held in Milan (Italy) in February 2020, and (3) a Delphi procedure to reach a final definition.
The CM was organized in three parts. Part 1: presentation and discussion of current definitions and related problems. Part 2: work in smaller groups to prepare a proposal of the new operational definition of rehabilitation for research purposes. Part 3: discussion and voting procedures on the proposal to be submitted to the Delphi procedure. The first round of the Delphi procedure will be conducted among the Meeting participants and the second round among the CR Advisory Board members. The results of the two rounds will be reviewed and synthesized, and a third Delphi round will be held again among the participants to the Meeting.
Results. During the Meeting it was decided that the proposed definition should contain all the essential key words that constitute the inclusion and exclusion criteria for research purposes, following the PICO (Population, Intervention, Control, Outcome) model as much as possible.
The current definition to be proposed for the Delphi Rounds is: In a health care context rehabilitation is: “a multimodal person-centered process, including functioning interventions targeting (1) body functions, and/or (2) activities and participation, and/or (3) the interaction with the environment” (Intervention), with the goal of “optimizing functioning” (Outcome) for “(1) persons with health conditions (a) experiencing disability or (b) likely to experience disability and/or (2) persons with disability” (Population).
This definition is currently provisional, and it should not be used until the final results of the Delphi are published.
Conclusions. These results will inform all the future work of CR and could also serve the scientific rehabilitation community.
Patient or healthcare consumer involvement. Representative of healthcare consumers are present in the Advisory Board of CR and contributed at all stages of the project when the Advisory Board was involved
Heterogeneity in search strategies among Cochrane acupuncture reviews: Is there room for improvement?
No full textObjective: Given the international focus and rigorous literature searches employed in Cochrane systematic reviews, this study was undertaken to evaluate strategies employed in Cochrane reviews and protocols assessing acupuncture as a primary or secondary intervention.
Methods: The Cochrane Collaboration of systematic reviews was searched in February 2009 for all reviews and protocols including information on acupuncture. Information was abstracted from all retrieved articles on review status, type and number of English and Chinese language databases searched, participation of at least one Chinese speaking author and language restriction. Frequencies were calculated and bivariate analyses were performed stratifying on interventions of interest to assess differences in search strategy techniques, language restrictions and results.
Results: The search retrieved 68 titles, including 48 completed reviews, 17 protocols and three previously withdrawn titles. Acupuncture was the primary intervention of interest in 44/65 (67.7%) of the retrieved reviews and protocols. While all articles searched at least one English language database, only 26/65 (40.0%) articles searched Chinese language databases. Significantly more articles where acupuncture was the primary intervention of interest searched Chinese language databases (53% vs 9%, p<0.01). Inconclusive findings as to the effectiveness of acupuncture were found in 28/48 (58.3%) of all completed reviews; this type of finding was more common in reviews which did not search any Chinese language databases.
Conclusions: It is important for reviews assessing the effectiveness of acupuncture to search Chinese language databases. The Cochrane Collaboration should develop specific criteria for Chinese language search strategies to ensure the continued publication of high-quality reviews
User involvement in a Cochrane systematic review: using structured methods to enhance the clinical relevance, usefulness and usability of a systematic review update
No full textBackground: This paper describes the structured methods used to involve patients, carers and health professionals in an update of a Cochrane systematic review relating to physiotherapy after stroke and explores the perceived impact of involvement.Methods: We sought funding and ethical approval for our user involvement. We recruited a stakeholder group comprising stroke survivors, carers, physiotherapists and educators and held three pre-planned meetings during the course of updating a Cochrane systematic review. Within these meetings, we used formal group consensus methods, based on nominal group techniques, to reach consensus decisions on key issues relating to the structure and methods of the review.Results: The stakeholder group comprised 13 people, including stroke survivors, carers and physiotherapists with a range of different experience, and either 12 or 13 participated in each meeting. At meeting 1, there was consensus that methods of categorising interventions that were used in the original Cochrane review were no longer appropriate or clinically relevant (11/13 participants disagreed or strongly disagreed with previous categories) and that international trials (which had not fitted into the original method of categorisation) ought to be included within the review (12/12 participants agreed or strongly agreed these should be included). At meeting 2, the group members reached consensus over 27 clearly defined treatment components, which were to be used to categorise interventions within the review (12/12 agreed or strongly agreed), and at meeting 3, they agreed on the key messages emerging from the completed review. All participants strongly agreed that the views of the group impacted on the review update, that the review benefited from the involvement of the stakeholder group, and that they believed other Cochrane reviews would benefit from the involvement of similar stakeholder groups.Conclusions: We involved a stakeholder group in the update of a Cochrane systematic review, using clearly described structured methods to reach consensus decisions. The involvement of stakeholders impacted substantially on the review, with the inclusion of international studies, and changes to classification of treatments, comparisons and subgroup comparisons explored within the meta-analysis. We argue that the structured approach which we adopted has implications for other systematic reviews.</p
Letter from Rich. P. Hammond to John T. Cochrane, 1855
No full textTransmit Port Warden's certificate on the appraisement of damages and auctioner's bill of sale of goods damaged during voyage of Challenge from New York to San Francisco
Neoadjuvant chemotherapy and surgery versus chemoradiotherapy for locally advanced cervical cancer
No full textObjectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. The aim of this review is to compare neoadjuvant chemotherapy (NACT) followed by radical surgery (RS) versus chemoradiotherapy (CRT) for locally advanced cervical cancer
Cochrane, T W, NX13473
No full textThis record was harvested from a previous catalogue system and will be withdrawn in 2025. Information in this record may be superseded or incomplete. Visit this record in UMA's new catalogue at: https://archives.library.unimelb.edu.au/nodes/view/377805Surname: COCHRANE
Given Name(s) or Initials: T W
Military Service Number or Last Known Location: NX13473
Missing, Wounded and Prisoner of War Enquiry Card Index Number: 1853191620
Item: [2016.0049.10101] "Cochrane, T W, NX13473
Electronic cigarettes for smoking cessation.
No full text"This Cochrane Review was published in the Cochrane Database of Systematic Reviews 2020, Issue 10. Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Cochrane Review."BACKGROUND: Electronic cigarettes (ECs) are handheld electronic vaping devices which produce an aerosol formed by heating an e-liquid. People who smoke report using ECs to stop or reduce smoking, but some organisations, advocacy groups and policymakers have discouraged this, citing lack of evidence of efficacy and safety. People who smoke, healthcare providers and regulators want to know if ECs can help people quit and if they are safe to use for this purpose. This review is an update of a review first published in 2014. OBJECTIVES: To evaluate the effect and safety of using electronic cigarettes (ECs) to help people who smoke achieve long-term smoking abstinence. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group's Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO for relevant records to January 2020, together with reference-checking and contact with study authors. SELECTION CRITERIA: We included randomized controlled trials (RCTs) and randomized cross-over trials in which people who smoke were randomized to an EC or control condition. We also included uncontrolled intervention studies in which all participants received an EC intervention. To be included, studies had to report abstinence from cigarettes at six months or longer and/or data on adverse events (AEs) or other markers of safety at one week or longer. DATA COLLECTION AND ANALYSIS: We followed standard Cochrane methods for screening and data extraction. Our primary outcome measures were abstinence from smoking after at least six months follow-up, AEs, and serious adverse events (SAEs). Secondary outcomes included changes in carbon monoxide, blood pressure, heart rate, blood oxygen saturation, lung function, and levels of known carcinogens/toxicants. We used a fixed-effect Mantel-Haenszel model to calculate the risk ratio (RR) with a 95% confidence interval (CI) for dichotomous outcomes. For continuous outcomes, we calculated mean differences. Where appropriate, we pooled data from these studies in meta-analyses. MAIN RESULTS: We include 50 completed studies, representing 12,430 participants, of which 26 are RCTs. Thirty-five of the 50 included studies are new to this review update. Of the included studies, we rated four (all which contribute to our main comparisons) at low risk of bias overall, 37 at high risk overall (including the 24 non-randomized studies), and the remainder at unclear risk. There was moderate-certainty evidence, limited by imprecision, that quit rates were higher in people randomized to nicotine EC than in those randomized to nicotine replacement therapy (NRT) (risk ratio (RR) 1.69, 95% confidence interval (CI) 1.25 to 2.27; I2 = 0%; 3 studies, 1498 participants). In absolute terms, this might translate to an additional four successful quitters per 100 (95% CI 2 to 8). There was low-certainty evidence (limited by very serious imprecision) of no difference in the rate of adverse events (AEs) (RR 0.98, 95% CI 0.80 to 1.19; I2 = 0%; 2 studies, 485 participants). SAEs occurred rarely, with no evidence that their frequency differed between nicotine EC and NRT, but very serious imprecision led to low certainty in this finding (RR 1.37, 95% CI 0.77 to 2.41: I2 = n/a; 2 studies, 727 participants). There was moderate-certainty evidence, again limited by imprecision, that quit rates were higher in people randomized to nicotine EC than to non-nicotine EC (RR 1.71, 95% CI 1.00 to 2.92; I2 = 0%; 3 studies, 802 participants). In absolute terms, this might again lead to an additional four successful quitters per 100 (95% CI 0 to 12). These trials used EC with relatively low nicotine delivery. There was low-certainty evidence, limited by very serious imprecision, that there was no difference in the rate of AEs between these groups (RR 1.00, 95% CI 0.73 to 1.36; I2 = 0%; 2 studies, 346 participants). There was insufficient evidence to determine whether rates of SAEs differed between groups, due to very serious imprecision (RR 0.25, 95% CI 0.03 to 2.19; I2 = n/a; 4 studies, 494 participants). Compared to behavioural support only/no support, quit rates were higher for participants randomized to nicotine EC (RR 2.50, 95% CI 1.24 to 5.04; I2 = 0%; 4 studies, 2312 participants). In absolute terms this represents an increase of six per 100 (95% CI 1 to 14). However, this finding was very low-certainty, due to issues with imprecision and risk of bias. There was no evidence that the rate of SAEs varied, but some evidence that non-serious AEs were more common in people randomized to nicotine EC (AEs: RR 1.17, 95% CI 1.04 to 1.31; I2 = 28%; 3 studies, 516 participants; SAEs: RR 1.33, 95% CI 0.25 to 6.96; I2 = 17%; 5 studies, 842 participants). Data from non-randomized studies were consistent with RCT data. The most commonly reported AEs were throat/mouth irritation, headache, cough, and nausea, which tended to dissipate over time with continued use. Very few studies reported data on other outcomes or comparisons and hence evidence for these is limited, with confidence intervals often encompassing clinically significant harm and benefit. AUTHORS' CONCLUSIONS: There is moderate-certainty evidence that ECs with nicotine increase quit rates compared to ECs without nicotine and compared to NRT. Evidence comparing nicotine EC with usual care/no treatment also suggests benefit, but is less certain. More studies are needed to confirm the degree of effect, particularly when using modern EC products. Confidence intervals were wide for data on AEs, SAEs and other safety markers. Overall incidence of SAEs was low across all study arms. We did not detect any clear evidence of harm from nicotine EC, but longest follow-up was two years and the overall number of studies was small. The main limitation of the evidence base remains imprecision due to the small number of RCTs, often with low event rates. Further RCTs are underway. To ensure the review continues to provide up-to-date information for decision-makers, this review is now a living systematic review. We will run searches monthly from December 2020, with the review updated as relevant new evidence becomes available. Please refer to the Cochrane Database of Systematic Reviews for the review's current status
Cochrane, W T J, NX11481
No full textThis record was harvested from a previous catalogue system and will be withdrawn in 2025. Information in this record may be superseded or incomplete. Visit this record in UMA's new catalogue at: https://archives.library.unimelb.edu.au/nodes/view/377804Surname: COCHRANE
Given Name(s) or Initials: W T J
Military Service Number or Last Known Location: NX11481
Missing, Wounded and Prisoner of War Enquiry Card Index Number: 7146191619
Item: [2016.0049.10100] "Cochrane, W T J, NX11481
The 3rd Cochrane Rehabilitation Methodology Meeting: "Rehabilitation definition for scientific research purposes"
No full textInterventions for the primary prevention of venous thromboembolism for hip fracture surgery
No full textThis is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effects of pharmacological or mechanical interventions, or both combined, for the primary prevention of venous thromboembolism in individuals undergoing hip fracture surgery
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